BMJ 2014;349:g4703 doi: 10.1136/bmj.g4703 (Published 22 July 2014)
Page 1 of 1
Letters
LETTERS HARMFUL MEDICAL OVERUSE
Italy’s “Doing more does not mean doing better” campaign Sandra Vernero general secretary, Gianfranco Domenighetti board member, Antonio Bonaldi president Italy’s Slow Medicine, Via Silvio Pellico, 24, Torino, Italy
Italy’s campaign “Doing more does not mean doing better” (Fare di più non significa fare meglio) was launched by Italy’s Slow Medicine (www.slowmedicine.it), a movement of doctors, other health professionals, patients, and citizens.1 It aims to promote measured, respectful, and equitable care.
Secondly, financial rewards for hospitals, even public ones, focus on quantitative results rather than qualitative ones. This hinders the drive towards reducing waste and increasing the appropriateness of testing and of treatment.
Implementation of the project will require informing and training physicians and other health professionals, as well as facilitating dialogue among the various health professionals, particularly between GPs and medical specialists.
Competing interests: None declared.
Nine lists have already been published,2 and many other societies of physicians and nurses are joining the project, as well as hospitals. The project’s main goal is to protect patients’ interests through a partnership between health professionals and patients and users, not to ration healthcare for cost cutting purposes.
Organisational changes will be necessary too—for example, radiologists need to become more involved in decisions about imaging, which is often inappropriate.3
There will be many challenges, of course. Firstly, many doctors claim to prescribe unnecessary tests and treatments because they are worried about malpractice claims (defensive medicine). We need to show them that shared decision making would protect them from complaints and litigation more effectively.
Also, the Italian media puts out the message that doing more is always better. Different ways of communicating with the public are therefore needed, starting from the institutional level, to deal with the problems of overtesting, overdiagnosis, and overtreatment.4
1 2 3 4
Hurley R. Can doctors reduce harmful medical overuse worldwide? BMJ 2014;349:g4289. (3 July.) Slow Medicine. www.slowmedicine.it/fare-di-piu-non-significa-fare-meglio/pratiche-arischio-di-inappropriatezza-in-italia.html. Cristofaro M, Busi Rizzi E, Schininà V, Chiappetta D, Angeletti C, Bibbolino C. Appropriateness: analysis of outpatient radiology requests. Radiol Med 2012;117:322-32. Domenighetti G, Vernero S. Fare di più non significa fare meglio. Salute Internazionale. info 8 maggio 2013. www.saluteinternazionale.info/2013/05/fare-di-piu-non-significa-faremeglio/.
Cite this as: BMJ 2014;349:g4703 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS HARMFUL MEDICAL OVERUSE
Italy’s “Doing more does not mean doing better” campaign Sandra Vernero general secretary, Gianfranco Domenighetti board member, Antonio Bonaldi president Italy’s Slow Medicine, Via Silvio Pellico, 24, Torino, Italy
Italy’s campaign “Doing more does not mean doing better” (Fare di più non significa fare meglio) was launched by Italy’s Slow Medicine (www.slowmedicine.it), a movement of doctors, other health professionals, patients, and citizens.1 It aims to promote measured, respectful, and equitable care.
Secondly, financial rewards for hospitals, even public ones, focus on quantitative results rather than qualitative ones. This hinders the drive towards reducing waste and increasing the appropriateness of testing and of treatment.
Implementation of the project will require informing and training physicians and other health professionals, as well as facilitating dialogue among the various health professionals, particularly between GPs and medical specialists.
Competing interests: None declared.
Nine lists have already been published,2 and many other societies of physicians and nurses are joining the project, as well as hospitals. The project’s main goal is to protect patients’ interests through a partnership between health professionals and patients and users, not to ration healthcare for cost cutting purposes.
Organisational changes will be necessary too—for example, radiologists need to become more involved in decisions about imaging, which is often inappropriate.3
There will be many challenges, of course. Firstly, many doctors claim to prescribe unnecessary tests and treatments because they are worried about malpractice claims (defensive medicine). We need to show them that shared decision making would protect them from complaints and litigation more effectively.
Also, the Italian media puts out the message that doing more is always better. Different ways of communicating with the public are therefore needed, starting from the institutional level, to deal with the problems of overtesting, overdiagnosis, and overtreatment.4
1 2 3 4
Hurley R. Can doctors reduce harmful medical overuse worldwide? BMJ 2014;349:g4289. (3 July.) Slow Medicine. www.slowmedicine.it/fare-di-piu-non-significa-fare-meglio/pratiche-arischio-di-inappropriatezza-in-italia.html. Cristofaro M, Busi Rizzi E, Schininà V, Chiappetta D, Angeletti C, Bibbolino C. Appropriateness: analysis of outpatient radiology requests. Radiol Med 2012;117:322-32. Domenighetti G, Vernero S. Fare di più non significa fare meglio. Salute Internazionale. info 8 maggio 2013. www.saluteinternazionale.info/2013/05/fare-di-piu-non-significa-faremeglio/.
Cite this as: BMJ 2014;349:g4703 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
